Tennessee could have an answer about expanding Medicaid by Christmas, Gov. Bill Haslam said Monday after groundbreaking for a new training facility in Smyrna.

"If we're going to get something done this legislative session we need to be able to have it defined, so we can start the process of explaining how it will work. Either way we'll have an answer really before Christmas," he said.

After budget hearings concluded last week, Haslam said he's talked with the Republican governors who expanded Medicaid for low-income people in their states, and he plans to announce what he will do by the end of the month.

The governor has been heavily criticized for refusing last year to agree to $1.4 billion in federal funds to cover about 180,000 uninsured Tennesseans under the terms the money was offered.

Since the Affordable Care Act was passed, Haslam has said he's trying to get federal officials to approve a "Tennessee plan" that is acceptable both to Washington and to largely skeptical Tennessee lawmakers, who must approve any deal under a law passed earlier this year.

"We have always said it should be something that won't cost the state extra money, No. 1 and, No. 2, was going to lead to better health outcomes for all our citizens," Haslam said Monday, adding the issue is complex and has taken longer than he expected to hash out.

And until a compromise can be worked out, he can't take anything to Tennessee's overwhelmingly Republican-controlled legislature, he said Monday.

"Quite frankly that's why it's taken so long," Haslam said Monday.

Because it's taken years, health-care advocates are becoming increasingly frustrated with Haslam's delay, particularly because those nine Republican governors expanded Medicaid and at least three more are in discussions with federal officials.

Michele Johnson, executive director of the Tennessee Justice Center, said other Republican governors have worked out deals and brought in federal funds.

"They have shown that it is possible, and that Tennessee should be able to do the same thing," said Johnson, a leading advocate for enrollees in TennCare.

Last week, Wyoming, which has a Republican governor, released a plan to expand Medicaid. The proposal, which still has to win federal and state legislative approval, would provide Medicaid coverage to an additional 17,600 low-income people, according to the state's health department.

Under the plan, those earning 100 to 138 percent of the federal poverty level — for a single person, $11,670 to $16,105 a year — would have to pay monthly premiums. The premiums could range from about $20 to $50 a month, depending on household size and income, according Kim Deti, spokeswoman for the Wyoming Health Department.

The nine Republican-governed states that have expanded Medicaid are Arizona, Iowa, Michigan, Nevada, New Jersey, New Mexico, North Dakota, Ohio and Pennsylvania.